Reduced Dose BCG in an Era of BCG Shortage: Real‐World Experience from a Tertiary Cancer Centre

2021 ◽  
Author(s):  
Niyati Lobo ◽  
Kelly K. Bree ◽  
Patrick J. Hensley ◽  
Graciela M. Nogueras‐Gonzalez ◽  
Prasanth Abraham ◽  
...  
Keyword(s):  
Real World ◽  
Cancer Centre ◽  
Reduced Dose

scholarly journals Real-World Data on Clinical Outcomes of Patients with Liver Cancer: A Prospective Validation of the National Cancer Centre Singapore Consensus Guidelines for the Management of Hepatocellular Carcinoma

Liver Cancer ◽  
2021 ◽  
pp. 1-16
Author(s):  
Xin Hui Chew ◽  
Rehena Sultana ◽  
Eshani N. Mathew ◽  
David Chee Eng Ng ◽  
Richard H.G. Lo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Clinical Outcomes ◽  
Real World ◽  
Compliance Rate ◽  
Locally Advanced ◽  
Consensus Guidelines ◽  
Real World Data ◽  
World Data ◽  
Cancer Centre

<b><i>Introduction:</i></b> Real-world management of patients with hepatocellular carcinoma (HCC) is crucially challenging in the current rapidly evolving clinical environment which includes the need for respecting patient preferences and autonomy. In this context, regional/national treatment guidelines nuanced to local demographics have increasing importance in guiding disease management. We report here real-world data on clinical outcomes in HCC from a validation of the Consensus Guidelines for HCC at the National Cancer Centre Singapore (NCCS). <b><i>Method:</i></b> We evaluated the NCCS guidelines using prospectively collected real-world data, comparing the efficacy of treatment received using overall survival (OS) and progression-free survival (PFS). Treatment outcomes were also independently evaluated against 2 external sets of guidelines, the Barcelona Clinic Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC). <b><i>Results:</i></b> Overall treatment compliance to the NCCS guidelines was 79.2%. Superior median OS was observed in patients receiving treatment compliant with NCCS guidelines for early (nonestimable vs. 23.5 months <i>p</i> &#x3c; 0.0001), locally advanced (28.1 vs. 22.2 months <i>p</i> = 0.0216) and locally advanced with macrovascular invasion (10.3 vs. 3.3 months <i>p</i> = 0.0013) but not for metastatic HCC (8.1 vs. 6.8 months <i>p</i> = 0.6300), but PFS was similar. Better clinical outcomes were seen in BCLC C patients who received treatment compliant with NCCS guidelines than in patients with treatment only allowed by BCLC guidelines (median OS 14.2 vs. 7.4 months <i>p</i> = 0.0002; median PFS 6.1 vs. 4.0 months <i>p</i> = 0.0286). Clinical outcomes were, however, similar for patients across all HKLC stages receiving NCCS-recommended treatment regardless of whether their treatment was allowed by HKLC. <b><i>Conclusion:</i></b> The high overall compliance rate and satisfactory clinical outcomes of patients managed according to the NCCS guidelines confirm its validity. This validation using real-world data considers patient and treating clinician preferences, thus providing a realistic analysis of the usefulness of the NCCS guidelines when applied in the clinics.

Radical Cancer Treatment is Safe During COVID-19: The Real World Experience of a Large London-Based Comprehensive Cancer Centre During the First Wave

2021 ◽  
Author(s):  
Beth Russell ◽  
Charlotte L. Moss ◽  
Maria Monroy-Inglesias ◽  
Graham Roberts ◽  
Harvey Dickinson ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Real World ◽  
The Real ◽  
Cancer Centre ◽  
Comprehensive Cancer Centre

Real world prospective experience of axitinib in metastatic renal cell carcinoma in a large comprehensive cancer centre

2017 ◽  
Vol 79 ◽  
pp. 185-192 ◽  
Author(s):  
Margarida Matias ◽  
Gwénaël Le Teuff ◽  
Laurence Albiges ◽  
Annalisa Guida ◽  
Caroline Brard ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Real World ◽  
Renal Cell ◽  
Cancer Centre ◽  
Comprehensive Cancer Centre

scholarly journals Renal function after liver transplantation: Real-world experience with basiliximab induction and delayed reduced-dose tacrolimus

2021 ◽  
Author(s):  
Anna Cederborg ◽  
Åsa Norén ◽  
Thijs Barten ◽  
Björn Lindkvist ◽  
William Bennet ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Renal Function ◽  
Real World ◽  
Reduced Dose

scholarly journals Development and implementation of a dynamically updated big data intelligence platform from electronic health records for nasopharyngeal carcinoma research

2019 ◽  
Vol 92 (1102) ◽  
pp. 20190255 ◽  
Author(s):  
Li Lin ◽  
Wei Liang ◽  
Chao-Feng Li ◽  
Xiao-Dan Huang ◽  
Jia-Wei Lv ◽  
...  
Keyword(s):  
Big Data ◽  
Electronic Health Records ◽  
Real World ◽  
Nasopharyngeal Cancer ◽  
Recall Rate ◽  
Health Records ◽  
Cancer Centre ◽  
Standard Data ◽  
Electronic Health ◽  
Data Elements

Objective: To develop a big data intelligence platform for secondary use of electronic health records (EHRs) data to facilitate research for nasopharyngeal cancer (NPC). Methods: This project was launched in 2015 and carried out by the cooperation of an academic cancer centre and a technology company. Patients diagnosed with NPC at Sun Yat-sen University Cancer Centre since January 2008 were included in the platform. Standard data elements were established to defined 981 variables for the platform. For each patient, data from 13 EHRs systems were extracted, integrated, structurized and normalized. Eight functional modules were constructed for the platform to facilitate the investigators to identify eligible patients, establish research projects, conduct statistical analysis, track the follow-up, search literature, etc. Results: From January 2008 to December 2018, 54,703 patients diagnosed with NPC were included. Of these patients, 39,058 (71.4%) were male, and 15,645 (28.6%) were female; median age was 47 (interquartile range, 39–55) years. Of 981 variables, 341 were obtained from data structurization and normalization, of which 68 were generated by interacting multiple data sources via well-defined logical rules. The average precision rate, recall rate and F-measure for 341 variables were 0.97 ± 0.024, 0.92 ± 0.030, and 0.94 ± 0.027 respectively. The platform is regularly updated every seven days to include new patients and add new data for existing patients. Up to now, eight big data-driven retrospective studies have been published from the platform. Conclusion: Our big data intelligence platform demonstrates the feasibility of integrating EHRs data of routine healthcare, and offers an important perspective on real-world study of NPC. The continued efforts may be focus on data sharing among multiple hospitals and publicly releasing of data files. Advances in knowledge: Our big data intelligence platform is the first disease-specific data platform for NPC research. It incorporates comprehensive EHRs data from routine healthcare, which can facilitate real-world study of NPC in risk stratification, decision-making and comorbidities management.

Real world eligibility for cabozantinib (C), regorafenib (Reg), and ramucirumab (Ram) in hepatocellular carcinoma (HCC) patients after sorafenib (S).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 422-422 ◽  
Author(s):  
Andrea S. Fung ◽  
Vincent C. Tam ◽  
Daniel E. Meyers ◽  
Hao-Wen Sim ◽  
Jennifer J. Knox ◽  
...  
Keyword(s):  
Real World ◽  
Performance Status ◽  
Outcome Data ◽  
Prognostic Impact ◽  
Eligibility Criteria ◽  
Cancer Centre ◽  
Kaplan Meier ◽  
Real World Evidence ◽  
Receive Treatment ◽  
New Treatments

422 Background: The CELESTIAL, RESORCE, and REACH-2 trials showed survival benefit of C, Reg, and Ram, respectively, when given after S to HCC patients. However, strict eligibility criteria (SEC) may limit generalizability. In clinical practice, modified eligibility criteria (MEC) may be used to offer treatments to select patients with slightly worse performance status (ECOG 2) or limited liver dysfunction (Child-Pugh (CP) B7). This study evaluated which patients in the real world would be eligible for these new treatments using SEC and MEC, and their prognostic impact. Methods: HCC patients who received S between 01/2008-06/2017 in British Columbia, Alberta, Princess Margaret Cancer Centre, and Sunnybrook Cancer Centre in Canada were included. Clinical, pathologic, laboratory and outcome data were collected. Patients were classified as eligible or ineligible based on available CELESTIAL, RESORCE, REACH-2 clinical trial SEC or MEC. Median overall survival (mOS) for these groups was assessed using the Kaplan-Meier method. Results: A total of 730 patients were identified. Using SEC, only 13.1% of patients would be eligible for C, Reg, or Ram (table). Expanding eligibility to include patients who meet MEC increased the proportion of eligible patients to 31.7%. Patients who met SEC had longer mOS compared to those who were ineligible. The most common reasons for not meeting SEC across all 3 trials were ECOG ≥ 2 (61.7%) and CP ≥ B (63.9%). Higher ineligibility for Reg or Ram was likely driven by strict trial-specific criteria, with 28.0% of patients ineligible for Reg due to S intolerance and 58.9% ineligible for Ram due to AFP < 400. Conclusions: Only a small proportion of real-world HCC patients would be eligible for C, Reg, or Ram based on SEC. More than twice as many patients would likely receive treatment if MEC were applied. If MEC are adopted, ongoing real-world evidence generation will be important to evaluate outcomes in these unstudied patient groups. [Table: see text]

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